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Blood Studies for Cardiovascular System I: Cardiac Biomarkers01:20

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Cardiac biomarkers are enzymes, proteins, and hormones released into the blood when cardiac cells are injured. They are powerful tools for triaging.
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Diagnosing acute coronary syndrome or ACS begins with a thorough patient history. Notable symptoms include central, crushing chest pain radiating to the left arm, neck, jaw, or back, along with shortness of breath, sweating (diaphoresis), nausea, vomiting, dizziness, and palpitations.It is crucial to note any history of cardiac illnesses and assess risk factors, including age, gender, smoking, hypertension, diabetes, hyperlipidemia, and a sedentary lifestyle.During physical examination, vital...
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Related Experiment Video

Updated: May 5, 2026

A Research Method For Detecting Transient Myocardial Ischemia In Patients With Suspected Acute Coronary Syndrome Using Continuous ST-segment Analysis
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Complete Versus Culprit-Only Revascularization in Older Patients With ST-Segment-Elevation Myocardial Infarction: An

Gianluca Campo1, Felix Böhm2, Thomas Engstrøm3

  • 1Cardiology Unit, Azienda Ospedaliero Universitaria di Ferrara, Cona, Italy (G.C., M.S., R.P., S.B.).

Circulation
|September 1, 2024
PubMed
Summary

Complete revascularization benefits older patients with ST-segment-elevation myocardial infarction up to 4 years. It significantly reduces cardiovascular death or myocardial infarction long-term, but not the primary composite endpoint at longest follow-up.

Keywords:
complete revascularizationmeta-analysismultivessel diseasemyocardial infarctionolder patients

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Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Geriatric Cardiology

Background:

  • Complete revascularization is standard for ST-segment-elevation myocardial infarction (STEMI) with multivessel disease.
  • The FIRE trial showed benefits in older patients but with limited follow-up.
  • Long-term benefits of complete revascularization in elderly STEMI patients remain debated.

Purpose of the Study:

  • To evaluate the long-term (>1 year) benefit of complete revascularization versus culprit-only revascularization.
  • To analyze individual patient data from randomized clinical trials in elderly STEMI patients (≥75 years).

Main Methods:

  • Systematic search of PubMed, Embase, and Cochrane databases for relevant randomized clinical trials.
  • Individual patient-level data meta-analysis of 7 trials including 1733 patients (816 complete, 917 culprit-only).
  • Primary endpoint: death, myocardial infarction, or ischemia-driven revascularization. Secondary endpoint: cardiovascular death or myocardial infarction.

Main Results:

  • Complete revascularization reduced the primary endpoint up to 4 years (HR 0.78).
  • At longest follow-up, the primary endpoint was not significantly reduced (HR 0.83).
  • Complete revascularization significantly reduced cardiovascular death or myocardial infarction long-term (HR 0.76).

Conclusions:

  • Complete revascularization offers significant benefits up to 4 years for elderly STEMI patients with multivessel disease.
  • Long-term, complete revascularization reduces cardiovascular death or myocardial infarction, though not the primary composite endpoint.
  • Long-term mortality did not differ between strategies.